摘要
【目的】探讨大面积Ⅲ度烧伤三种手术方法的效果和特点。【方法】1985年1月至2008年12月应用保痂肉芽创面植皮、切痂微粒皮植皮、削痂微粒皮植皮三种治疗方法，处理156例大面积Ⅲ度烧伤创面并对治疗结果进行分析。【结果】创面平均愈合时间：保痂肉芽创面植皮组（65．6±9．8）d，切痂微粒皮植皮组（53．8±9．2）d，削痂微粒皮植皮组（45．5±9．5）d。保痂组病程长，病人消耗大，并发症发生率高，死亡几率增大；切痂组手术损伤重，对病人烧伤后第二次打击大，愈后外形和功能差，丧失了皮肤附属器，对功能康复影响大；削痂组创面愈合快，并发症少，疤痕平坦、柔软。【结论】伤后及时清除坏死组织，对创面进行有效的覆盖，对加快创面愈合，减少创面侵袭性感染，减少脓毒症的发生，保护各脏器的功能，缩短病程，减少医疗费用非常重要。削痂微粒皮植皮治疗大面积Ⅲ度烧伤，可保留皮肤组织的部分功能，减少疤痕，愈后外形和功能良好。
[Objective]To explore the effects of three surgery methods for depth wounds in extensively burned patients. [Methods]The results of three surgical methods including conservative granulation wound sk ingrafting, eschar excision microparticle skingrafting and tangential excision microparticle skingrafting were analyzed retrospectively in 156 cases with extensive deep burn during Jan. 1985 and Sept. 2008. [Results]The average healing time in groups of conservative granulation wound skingrafting, eschar excision microparticle skingrafting and tangential excision microparticle skingrafting were 65.6 ± 9.8, 53.8 ± 9.2 and 45.5 ±9.5 days, respectively. The patients in conservative granulation wound skingrafting group had longer length of stay time, more consumption, higher incidence of complications and mortality rate. The patients in eschar excision microparticle skingrafting group had severe surgical trauma, the second trauma after burn, unsatisfactory appearances and poor functions which resulted in the loss of skin appendages and influenced the rehabilita- tion of the function. The patients in tangential excision microparticle skingrafting group had quicker healing, less complications, flatter and softer scars. [Conclusion] Removing the necrotic tissue in time and covering wound surface effectively are benefit to quicken the wound healing, reduce infection and the incidence of sepsis, protect organs, shorten the course of disease and decrease the medical cost. Tangential excision microparticle skingrafting for treating extensive deep burn can retain partial function of skin tissue, reduce scar formation and obtain better shape and function.
出处
《医学临床研究》
CAS
2010年第1期45-47,共3页
Journal of Clinical Research
